HomeMy WebLinkAbout1999-011336 - detached accessory � PERMIT
�;ITY OF ORONO PERMIT TYPE:
3750•Kelley Parkway - P.O. Box 66 = _;;�_:_;�7 i�w::
',rystal Bay, Minnesota 55323 Permit Number: _ _ _
Date Issued: �'' ` �'�'��'
612) 473-7357 _ . . _...... . _ _
SIT� t�DDRESS:
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DESCRIPTION:
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APPLICANT PERMITEE SIGN TURE ISSUED BY:SIGNATURE
.Total �ee: $ �.� `� ''• � `:' Date Received: ;� �.. ��
Entered By: ('� Permit#: ,�l� ?�.L-t
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) WNE�OR CONTRACTOR
JOB SITE ADDRESS: ���'/� CL'`?� �'��- ZIP: �5 3 ��,
NAME OF OWNER: ��i���`ln�" ��U ��G�-1b ✓� PHONE: (home) � I� - `�7 3�"�,�-�C:,
(work)
MAII,ING ADDRESS: `i�-(S ��c;;� �L�vvr. J�c� CITY: [�r�.°l� r: ,M�1/ ZIP: � 3 7 4=
--r—
CONTRACTOR: (� G�5� �L �� ►-�,� ,�- v� � rti'1 PHONE: �; �� - �13 y ' ���
CONTACT PERSON: l�� I ry��t 1 MOBILE/PAGER: ��G• �- �3 I �
MAILING ADDRESS: � �; `��`i �uP�✓ r r' CITY: ���,;;� r r A I�l� ZIP: 5 5 � 4 7
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure�__
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �f' r�r,,, h,,,, ����c; c� c1(�{-u�6u���� �h���It.� e:� v�
� J
�'�,v ti c t('�L (�T )C C. C,�k l.� C ��-( �'1.'1-� Gt�'(,4'w l��G� �
STORIES: l SQ. FEET OF EACH FLOOR: I�� f�f �
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ( �6 ��U U
I hereby apply for a building pernut and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Building Code; that I understand this is not a pernut and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: ����,�f fte';,;,ti V �lc w�Y!l�� DATE: ��- �"%��_
NOTE! Parade Qt'Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.04 RIGHTS OF S[JB.TECTS OF D�TA
Subd. 1. Type of data. The righ[s of individual on whom the data is stored or[o be stored shall be as set focth in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply privace or confidendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requesud data within the collecting'stare agency,polirical subdivision,or sracewide system;
(b)whe[her he may refuse oY is legally required to supply[he cequested data;(c)any Irnown consequence arising from his supplying or refusing to supply
priva�e or confidendal data;and(d)the idenriry of other persons or entides authorized by state or federal law to receive the data. This requiremeot shall
not apply when an individual is asked to supply invesrieadve dara, pursuant to secaon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of re�enue mav piace the norice reauired under this subdivision in the individual income tax or propem tax refund
instruccions inscead of on rhose forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible auchority,an individual shall be informed whether he is the subject
of stored data on individuais, and whether ic is classified as public, private or confidendal. Upon 6is funher request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wifiout any charge to him and,if he desires, shall be informed of the content
and meaning of chat data. After an individual has been shown the private data and informed of irs meaning,the data need not be disclosed to hirn for
siz months thereafter unless a dispute or acrion pursuanc to this secdon is pending or addidonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual cosu of making, cerrifying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compiy wi[h the request
within tha[time,he shall so inform the individual,and may have an addirional five days wi[hin which to comply wi�h the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shall notify in wriring the responsible authoriry describing the narure of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of
inaccurate or incomplete data, including recipients named by the individual; or(b)noafy the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the adaunistrarive procedure act relaring to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri;hts of subjects of data", we would like to inform you that your request
for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to process
the pemut or license.
4. If your requested pernut or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middie Last
Address
Ciry State Zip Phone
I understand my rights as stated above.
Signature
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: q y 5 C.�x �A fz�^ ��-�
PID:
DESCRIPTION OF WORK: ��x,c�+��D ��c.�s s n� ��-+��
--------____--_-------- - ----- ---1--------------------
ZOYI�i'G REYIE`V BY: DATE APPROVED: `/-�S-S�/
BUILDING REVIEW BY: DATE APPROVED: y-c s- S�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes � No SEWER CONNEC'ITON
STATE SURCHARGE Yes ✓ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
---------------------------------------------------------------------------------------------------------
ZONING CH�CK LIST Zoning District: L(L-1 A
Fire Department: (.,t�N G Lf�K-C Post Office: ���G V��u= School District: C�(ZDN�
Lot Area: Sq.ft. NO CI-4AN(��. Acres Width Depth
Survey Submitted: Yes� No Date of Survey: Q►�s �'��Vc
Proposed Setbacks: � �
Front (Lake): 1�0 � Right Side: �S +
Rear (Street): 1�� } Left Side: �3 Z� �
Adjacent Structures: ��� �= Wetland: N ��
Building Height: Def. Hgt. (�, k- Peal:Hgt. —'
Lot Coverage: � ��
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
oning File: # Resolution: # Resolution Date:
horeland District:
Avg. Setback: Bluff Setback: L.ot Coverage:
�� Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
ardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
BUILDING REVIEW CHECK LIST
�C� _ /Z'3 CONSTRUCTION TYPE: �V/"
Sq Footage $Per Sq Ftg
Basement x _
lst Floor x _
2nd Floor x =
Garage R _
R =
TOTAL
Estimated Construction Value: $_ I I, OOd�
,,
Inspections Required: `Vork Requiring Separate Permits:
S ite Plumbing Fire
Hardcover Removal Mechanical Water Connection
�C Footing ' Septic Sewer Connection
�Y Framing Firepiace Lawn Irrigation
_�Insulation (Masonry) Other
Wall Board
—�. . (r'Ifg•) Well (State Permit)
_�.F�� Grading/Filling p� Electrical (State Permit)
Other
REMARKS(IN HOUSE): ~ ����
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy:
---------------------------------------------------------
REMARKS (TO BE NOT'ED ON PER��fIT�: �,p,� �710,� & F Pv(� (�,� �1
v�/Ll: �_-�fZ���t/� iu.—U��c,J
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GL�551G STRUGTURES ING.
1 65�5 BEVERLY DRIYE EDEN PRA�IRIE MINNESOT� 5534�
GONSTRUGTION - M�4Nf46�MENT- GONSUL.TIN6 (6 1 2) q 3 4- 1 4 q 2
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�i'��::��e�;xne��ts are ror y�ur ir;fcr.m,ai;vr..F,iI NOi�d SF13i1 be d�ne
ir� ;,::1 c�mp�;a;?r�a i���n a^ appiic�le baiiding and zoning code.
Requira�e:itsinc;a�;ng i'�.,�s noi s;:�cifcal!,f:�oted in t�is r@view.
KEEP THti i'tAiV S�7 O!V SITC AT ALL T1AAE�S
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GL�551G STRUGTURES iNG.
1 65�5 BBVERLY DRIYE �D�N PR�IRIE MINNE50T,4 55347
� GON5TRUGTION - MhNA6EMENT- GON5ULTIN6 (6 1 2) 9 34- 1 4 9 2
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GL�551G 5TRUGTURE5 ING.
1 65�5 BEVERLY DRIVE ED N PRA�IRIE MINNFSOT�4 55 s�7
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CITY OF ORONO CALLED IN �T�"�� �'� CJ
INSPECTION NOTI. E., scHEou�E� '� ��Gt5
PERMIT NO. �l �j� COMPLETED
ADDRESS -� � �-
OWNER �!�i.2sC� .a. R. C���e ���zl��-�t2a�
TELEPHONE NO. 9.�� ����,�
� DESCRIPTION
l� 01 FOOTING 11 MECH I AL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHA ICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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� �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
u INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contract�Flon site:
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Inspector. �,v��''
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN � /9/�'
INSPECTION NOTICE SCHEDULED �/��'S' "D a
PERMIT NO. co PLETED �< `�
ADDRESS �
OWNER CONTR.
TELEPHONE NO. '�7 3 — �.z.Z.�
� DESCRIPTION ����it�_e�ti �
ty O1 FOOTING 11 MECHA AL RI 18 EXCAV/GRADING/FILLING
� 02 FR 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATIO 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
�MBING FINAL 36 FOUNDATION/REMOVAL
OWNE ICONTRACTOR TO MEET YOU:�S_NO
v, COMMENTS:
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Wi�TWORK SATISFACTORY:PROCEED i.-; PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
�: CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARFiANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContrac n e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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